Do you counsel on the onset of action? Nitrazepam (Mogadon and Alodorm) is a benzodiazepine commonly prescribed for sleep. Do you know the best time to take it?
Imagine being a patient. You have just been prescribed nitrazepam to help you sleep. You take the tablet before bed like the Consumer Medicines Information (CMI) says. Half an hour has past and you’re still awake. An hour goes by and you are still counting sheep. Now it’s been two hour. Still awake. What is going on?? Does this $#!^ even work!!!
Unless you are looking at the pharmacokinetics, no reference gives an indicator on the time to onset. The CMI says “take the tablet before going to bed,” surely we can do better than that. Absorption is listed as “fairly rapidly absorbed from the GI tract.”And the “time to reach PEAK plasma concentrations… is about 2 hours with a range of 0.5 – 5 hours.”
Now peak concentration is NOT the onset of action. But it does give us an indicator on it. So next time, before giving out nitrazepam, let the patient know that they may need to adjust the timing on when to take it.
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Posted by Memorise Medicine on Wednesday, July 25, 2018
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